| Provider Type: | Allopathic & Osteopathic Physicians |
| Provider Classification: | Radiology |
| Provider Specialization: | Diagnostic Radiology |
| Definition of Specialization: | |
| Address: |
601 Bluebird Blvd Fort Valley, GA 31030-5082 |
| Phone: | (478) 825-0310 |
| Authorized Official: | Dover, Greg L, CPA |
| Authorized Official Position: | Practice Manager |
| Authorized Official Phone: | (770) 237-1558 |
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